斯里兰卡缺血性心脏病的患病率和流行病学特征。

The Prevalence and Epidemiological Features of Ischaemic Heart Disease in Sri Lanka.

机构信息

Institute for Health Policy, 72 Park Street, Colombo 00200, Sri Lanka.

Erasmus School of Economics and Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Postbus 1738, 3000 DR Rotterdam, The Netherlands.

出版信息

Glob Heart. 2024 Jun 3;19(1):49. doi: 10.5334/gh.1330. eCollection 2024.

DOI:10.5334/gh.1330

PMID:38854432

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11160409/

Abstract

BACKGROUND

There is limited evidence on the prevalence of ischaemic heart disease (IHD) and its association with risk factors and socioeconomic status (SES) in low- and middle-income countries (LMICs). Given the relatively high levels of access to healthcare in Sri Lanka, the association of IHD with SES may be different from that observed in other LMICs.

OBJECTIVES

To estimate the prevalence of IHD in Sri Lanka, determine its associated risk factors and its association with SES.

METHODS

We analysed data from 6,513 adults aged ≥18 years examined in the 2018/19 Sri Lanka Health and Ageing Study. We used the Rose angina questionnaire to classify participants as having angina (Angina+) and used self-report or medical records to identify participants with a history of IHD (History+). The association of Angina+ and History+ with age, ethnicity, sector of residence, education level, household SES wealth quintile, area SES wealth quintile, hypertension, diabetes, smoking, total cholesterol, cholesterol-to-HDL ratio, waist-to-hip ratio and body mass index were analysed in unadjusted and adjusted models. Additional analyses were performed to investigate sensitivity to correction for missing data and to benchmark estimates against evidence from other studies.

CONCLUSIONS

We estimated prevalence of History+ of 3.9% (95% CI 3.3%-4.4%) and Angina+ of 3.0% (95% CI 2.4%-3.5%) in adults aged 18 years and over. The prevalence of Angina+ was higher in women than men (3.9% vs. 1.9%, p < 0.001) whilst prevalence of History+ was lower (3.8% vs. 4.0%, p = 0.8), which may suggest a higher rate of undiagnosed IHD in women. A history of IHD was strongly associated with age, hypertension and diabetes status even after adjusting for sociodemographic factors. Though the prevalence of History+ was higher in the most developed area SES tertile and urban areas, History+ was also associated with less education but not household SES, consistent with patterns emerging from other LMICs.

摘要

背景

在中低收入国家（LMICs），关于缺血性心脏病（IHD）的流行情况及其与危险因素和社会经济地位（SES）的关系，证据有限。鉴于斯里兰卡相对较高的医疗保健可及性，IHD 与 SES 的关联可能与其他 LMICs 观察到的不同。

目的

估计斯里兰卡 IHD 的流行情况，确定其相关危险因素及其与 SES 的关联。

方法

我们分析了 2018/19 年斯里兰卡健康与老龄化研究中 6513 名年龄≥18 岁成年人的数据。我们使用 Rose 心绞痛问卷将参与者分为心绞痛（Angina+）组和有 IHD 病史（History+）组。使用自我报告或医疗记录来识别 History+参与者。在未调整和调整模型中，分析了 Angina+和 History+与年龄、族裔、居住部门、教育水平、家庭 SES 财富五分位数、地区 SES 财富五分位数、高血压、糖尿病、吸烟、总胆固醇、胆固醇与高密度脂蛋白比值、腰臀比和体重指数之间的关联。进行了额外的分析，以调查对缺失数据校正的敏感性，并将估计值与其他研究的证据进行基准比较。

结论

我们估计年龄在 18 岁及以上的成年人中 History+的患病率为 3.9%（95%CI 3.3%-4.4%），Angina+的患病率为 3.0%（95%CI 2.4%-3.5%）。女性的 Angina+患病率高于男性（3.9%比 1.9%，p<0.001），而 History+的患病率较低（3.8%比 4.0%，p=0.8），这可能表明女性中未确诊的 IHD 发生率较高。即使在调整了社会人口因素后，IHD 病史也与年龄、高血压和糖尿病状态密切相关。尽管 History+在 SES 最发达地区 tertile 和城市地区的患病率较高，但 History+也与教育程度较低有关，但与家庭 SES 无关，这与其他 LMICs 出现的模式一致。